Pancreatic cancer has one of the worst prognosis with a 5 year overall survival (OS) rate of 6% (Hosein P et al. BMC Cancer 2012, 12:199). In general, curative therapy is only achieved through surgery where all gross disease is resected and surgical margins are microscopically free of disease (R0). Unfortunately, only about 10-20% of patients are candidates for surgery at diagnosis, i.e., have resectable LAPC. A further 30-40% of newly diagnosed patients present with LAPC, but are not candidates for surgery because vascular encasement by tumor renders the disease unresectable.
In an effort to increase the overall survival rate, induction therapy has been under investigation at multiple centers to “downstage,” LAPC, i.e., convert unresectable tumors into at least borderline resectable status, thereby making LAPC patients candidates for surgery. A recent literature review demonstrates that induction therapy has about a 33% success rate in downstaging eligible LAPC patients (Gillen S, et al. PLoS Med 2010 7(4):e1000267). Successfully downstaged LAPC patients that undergo tumor resection that achieves R0 margins have similar survival rates to LAPC patients that present with resectable disease.
Further improvements in induction therapies are required to increase the percentage of LAPC patients that are elible for tumor resection. Induction therapies comprising an anti-CTGF agent can address this pressing medical need.